Alumni Awards Nomination Form

Alumni Awards Nomination Form
Date

MonthDayYear
Date
1. Nominator Information
First Name*
Last Name*
Email*
Address
Address
City
State
Zip
Phone*
2. Nominee Information
First Name*
Last Name*
Degree Year
City
State
Zip
Nominee's Preferred Email - old field/hidden
Please share the nominee's preferred email
Phone
Nominated for which award?*
3. Tell Us More: The information submitted by the nominator will guide the decision of the selection committee, members of the Alumni Board, or their appointees.
How does this alumnus/a embody the spirit of Wittenberg? How are they passing their light?

0/250
Please describe your nominee’s achievements, contributions of service, or other qualifications as they relate to the award criteria. Please include any honors, awards, distinctions, professional societies and volunteer work. *

0/250
Please provide a link to a bio or LinkedIn page.
Please list any additional nominators or references with grad year if applicable.
Occasionally the selection committee sees a need to move a nomination to a different category. Are you open to other award selections for your nominee?

yesno
Should be Empty: